Postoperative insole-paedobarographic gait analysis for patients with flap coverages of weight-bearing and non-weight-bearing areas of the foot

摘要

Functional results regarding shoe modifications, gait analysis and long-term durability of the reconstructed foot have not been reported using insole paedobarography. This article presents insole-paedobarographic gait analysis and discusses the various pressure distribution patterns following the reconstruction of the foot. This retrospective study reports on the clinical and functional results in 23 out of 39 patients who received flap coverage of their feet in our department in the period from 2001 to 2010. Mean follow-up time amounted to 46.6 months. Patients were separated into two groups, those with flap coverage to the sole of the foot (group 1) and those with flap coverage to non-weight-bearing areas of the foot (group 2). Gait analysis was accomplished by using insole paedobarography. The results of the gait analysis have shown that in both patient groups, when comparing affected feet with sound feet, the affected feet were exposed to significantly less support time (group 1; affected vs. sound feet: 0.44 ± 0.07 s vs. 0.55 ± 0.11 s, p = 0.047), (group 2; affected vs. sound feet: 0.47 ± 0.07 s vs. 0.54 ± 0.07 s, p = 0.029). In addition, in both patient groups, the analysis of peak-pressure distributions revealed greater pressures on the affected feet compared to the sound feet (group 1; affected vs. sound feet: 47.9 ± 10.13 N cm -2 vs. 36.3 ± 7.5 N cm -2, p = 0.008), (group 2; affected vs. sound feet: 38.08 ± 13.98 N cm -2 vs. 32.92 ± 14.77 N cm -2, p = 0.061). The insole paedobarography can contribute to a more precise gait analysis following a soft-tissue reconstruction not only of the sole but also of other foot regions as well. It can help to identify and correct movement sequences and peak-pressure distributions which are damaging to the flaps. The resulting potential minimisation of the ulceration rate can lead to a further optimisation in the rate of completely rehabilitated patients and a reduction in the revision rate.